Article
Author: Bedbrook, A. ; Makela, M. ; Samolinski, B. ; Klimek, L. ; Rivero Yeverino, D. ; Kuna, P. ; Canonica, G.W. ; Ollert, M. ; Agache, I. ; Usmani, O.S. ; Jutel, M. ; Gemicioglu, B. ; Shamji, M.H. ; Puggioni, F. ; Buhl, R. ; Cecchi, L. ; Ivancevich, J.C. ; Kraxner, H. ; Anto, J.M. ; Pétré, B. ; Haahtela, T. ; Nadif, R. ; Amaral, R. ; Boulet, L.-P. ; Robalo Cordeiro, C. ; Papadopoulos, N.G. ; Bonini, M. ; Zuberbier, T. ; Bousquet, J. ; Morais-Almeida, M. ; Ventura, M.T. ; Costa, E.M. ; Patella, V. ; Czarlewski, W. ; Fonseca, J.A. ; Roche, N. ; Brusselle, G. ; Sá-Sousa, A. ; Chaves Loureiro, C. ; Louis, R. ; Kupczyk, M. ; Becker, S. ; Bergmann, K.C. ; Sastre, J. ; Sousa-Pinto, B. ; Brussino, L. ; Romantowski, J. ; Regateiro, F.S. ; Laune, D. ; Sheikh, A. ; Valiulis, A. ; Niedoszytko, M. ; Yorgancioglu, A. ; Savouré, M. ; Scichilone, N. ; Charpin, D. ; Bosnic-Anticevich, S. ; Suppli Ulrik, C. ; Larenas-Linnemann, D.E. ; de Blay, F. ; Pfaar, O. ; Papi, A. ; Taborda-Barata, L. ; Cruz, A.A. ; Pham-Thi, N. ; Okamoto, Y. ; Kvedariene, V. ; Rouadi, P.W. ; Del Giacco, S.
INTRODUCTION:Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA.
MATERIALS AND METHODS:We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day.
RESULTS:In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001).
CONCLUSIONS:In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.